Non-local impact of distal airway constrictions on patterns of inhaled particle deposition.

Airway constriction and blockage in obstructive lung diseases cause ventilation heterogeneity and create barriers to effective drug deposition. Established computational particle-deposition models have not accounted for these impacts of disease. We present a new particle-deposition model that calculates ventilation based on the resistance of each airway, such that ventilation responds to airway constriction.

Urothelial Malignancy After Normal Hematuria Clinic Investigations: Does Non-visible Hematuria Need Reinvestigation?

Objective:  Hematuria is the most common referral to Urology. Most initial evaluations are normal; however there are few medium- to long-term studies about these patients after they are discharged.

Methods:  This study was a retrospective observational case-control study.

Do Concomitant Systematic Biopsies Add to Fusion Targeted Biopsies in the Diagnosis and Management of Clinically Significant Prostate Cancer?

Objective: Magnetic resonance imaging targeted biopsy clearly detects more clinically significant prostate cancer than systematic biopsy. Whether concomitant systematic biopsy adds to targeted biopsy in the detection of clinically significant prostate cancer remains uncertain. The primary outcome measure of this study was to ascertain the percentage of clinically significant prostate cancer on systematic biopsy missed by targeted biopsy.

Surfactant amplifies yield-stress effects in the capillary instability of a film coating a tube.

To assess how the presence of surfactant in lung airways alters the flow of mucus that leads to plug formation and airway closure, we investigate the effect of insoluble surfactant on the instability of a viscoplastic liquid coating the interior of a cylindrical tube. Evolution equations for the layer thickness using thin-film and long-wave approximations are derived that incorporate yield-stress effects and capillary and Marangoni forces. Using numerical simulations and asymptotic analysis of the thin-film system, we quantify how the presence of surfactant slows growth of the Rayleigh-Plateau instability, increases the size of initial perturbation required to trigger instability and decreases the final peak height of the layer.

The influence of invariant solutions on the transient behaviour of an air bubble in a Hele-Shaw channel.

We hypothesize that dynamical systems concepts used to study the transition to turbulence in shear flows are applicable to other transition phenomena in fluid mechanics. In this paper, we consider a finite air bubble that propagates within a Hele-Shaw channel containing a depth-perturbation. Recent experiments revealed that the bubble shape becomes more complex, quantified by an increasing number of transient bubble tips, with increasing flow rate.

Pregnant women with opioid use disorder and their infants in three state Medicaid programs in 2013-2016.

Background: Maternal opioid use disorder (OUD) has serious consequences for maternal and infant health. Analysis of Medicaid enrollee data is critical, since Medicaid bears a disproportionate share of costs.

Methods: This study analyzes linked maternal and infant Medicaid claims data and infant birth records in three states in the year before and after a delivery in 2014-2015 (2013-2016) examining health, health care use, treatment, and neonatal outcomes.

Sequential deposition of microdroplets on patterned surfaces.

We use a combination of experiments and numerical modelling to investigate the influence of physico-chemical-patterned substrates on the spreading of fluid deposited as a partially overlapping sequence of droplets via inkjet printing. Our investigation is motivated by the manufacture of polymeric organic light-emitting-diode displays, where the substrate is textured with a regular array of shallow recessed regions (pixels) that are highly wetting compared to the remainder of the substrate. We examine the roles of topography and wettability patterning separately and in combination.

Bubble propagation on a rail: a concept for sorting bubbles by size.

We demonstrate experimentally that the introduction of a rail, a small height constriction, within the cross-section of a rectangular channel could be used as a robust passive sorting device in two-phase fluid flows. Single air bubbles carried within silicone oil are generally transported on one side of the rail. However, for flow rates marginally larger than a critical value, a narrow band of bubble sizes can propagate (stably) over the rail, while bubbles of other sizes segregate to the side of the rail.

Population Health Measurement at Centers for Medicare & Medicaid Services: Bridging the Gap Between Public Health and Clinical Quality.

As Medicare and Medicaid increasingly shift to alternative payment models focused on population-based payments, there is an urgent need to develop measures of population health that can drive health improvement. In response, an assessment and design project established a framework for developing population health measures from a payer perspective, conducted environmental scans of existing measures and available data infrastructure, and conducted a gap analysis informing measure development and infrastructure needs. The work, summarized here, makes recommendations for creating a set of core measures, demonstrates some of the key challenges in applying a traditional quality measure development framework to population health, and complements recent efforts by the National Academy of Medicine and others with a focus on a payer perspective.

A Male Promotores Network for Latinos: Process Evaluation From a Community-Based Participatory Project.

Background Lay health advisor (LHA) interventions with Latino men are rare, especially in emerging Latino communities. We present a process evaluation of a male LHA network aiming at connecting Latino men to various kinds of services and to the Latino community. It assesses the feasibility of (1) maintaining a steering coalition; (2) hiring, training, and retaining male LHA; and (3) recruiting and assisting underserved participants.

Improving drug chart documentation in elective surgical patient admissions.

National Institute for Health and Care Excellence (NICE) guidelines state that all healthcare organisations should put policies in place for medication reconciliation on admission. At Croydon University Hospital a medication history had previously been taken in Foundation Year 1 (FY1) preoperative clinics. However, when these clinics were deemed unnecessary, this opportunity for drug chart documentation was lost, along with an awareness of this responsibility among the FY1s.

Anti-embolism stockings and proximal indentation.

The authors of this study noticed that the elastic garters of below knee anti-embolism stockings (AES) were indenting the proximal calves of patients after application and feared this might be interrupting venous return. This was lower on one ward which had a rigorous standardized protocol for sizing and checking stockings. Hypotheses were that proximal indentation caused higher proximal than distal pressures (reverse gradients) and that by adopting the standardized protocol throughout the unit, proximal indentation could be reduced.

The importance of narcissism in predicting proactive and reactive aggression in moderately to highly aggressive children.

The present study examined the importance of psychopathy-linked narcissism in predicting proactive and reactive aggression and conduct problems in a group of 160 moderately to highly aggressive children (mean age of 10 years, 9 months). Children's self-report of self-esteem and parent and teacher report of dimensions of psychopathy [narcissism, callous-unemotional (CU) traits, and impulsivity], proactive and reactive aggression, and conduct problems were collected. Composites of parent and teacher ratings of children's behavior were used.